Denial Management Specialist

Nevada Regional Medical Center • Nevada, MO

1d

About The Position

The Denials Management Specialist will be responsible for denials. The above statements are intended to describe the general nature and level of work performed by employees within this classification. It is not designed to contain or be interpreted as a comprehensive inventory of all duties, responsibilities and qualifications required of employees assigned to this job.

Requirements

• Ability to communicate clearly and effectively with all levels
• Ability to complete competency CPR and First Aid
• Ability to prioritize and complete multiple tasks simultaneously.
• Effective oral and written communication, analytical and problem solving skills.
• Experience in hospital billing or denial management preferred.
• Ability to interpret EOBs and knowledge of payer rules, medical terminology and basic coding concepts.
• High attention to detail.
• High school diploma or equivalent.
• Ability to meet productivity and quality standards.
• Ability to work independently and as part of a team.
• Strong follow-through and persistence when working with payers.
• Ability to collaborate with billing, coding, registration, utilization review and clinical teams.
• Understanding of HIPAA and patient privacy regulations.

Nice To Haves

• 2+ years of experience
• Familiarity with hospital billing systems

Responsibilities

• Review and resolve insurance claim denials.
• Submit timely, well-supported appeals for follow-up.
• Identify denial trends and collaborate with teams to prevent recurring issues.
• Communicate with payers regarding coverage, authorization and claim status.
• Document all actions and maintain accurate records in billing system.
• Process and respond to attorney requests for patient billing records.
• Ensure denial handling aligns with payer contract terms and identify any reimbursement discrepancies for correction.
• Collaborate with revenue cycle teams.
• Complete other duties as assigned to support department operations.

What This Job Offers

• Job Type: Full-time
• Career Level: Entry Level
• Education Level: High school or GED
• Number of Employees: 101-250 employees